Hydrocephalus

The first documented use of sUicone as biomaterial was silicone mbber tubing as shunts for treatment of hydrocephalus in about 1955. From 1960 to 1990, the biomedical application of sUicone mbber was steadUy grown. One of the most well-known silicone product is the Norplant contraceptive implant. The first clinical experiment with this device was reported in 1966. FDA approved its use in 1990. 

An alternative method of managing patients with cerebellar infarction causing obstructive hydrocephalus is endoscopic third ventriculostomy. Baldauf et al. ° reviewed 10 cases managed by the use of endoscopic third ventriculostomy, 8 of whom had clinical improvement (measured as an improvement in the level of consciousness). This therapy is still experimental, and improvement in outcome has not been demonstrated. 

Baldauf J, Oertel J, Gaab MR, Schroeder HW. Endoscopic third ventriculostomy for occlusive hydrocephalus caused hy cerehellar infarction. Neurosurgery 2006 59(3) 539-544. Schwab S, Aschoff A, Spranger M, Albert F, Hacke W. The value of intracranial pressure monitoring in acute hemispheric stroke. Neurology 1996 47(2) 393-398. 

Sander and Burkle (31) were the first to induce tumors by feeding nitrite and amines or amides. The tumors were attributed to in vivo formation of the N-nitroso compounds, probably in the stomach. When pregnant rats were gavaged with ethylurea and nitrite, hydrocephalus and nervous system tumors were induced in the offspring. Both these effects were prevented when sodium ascorbate was gavaged together with the ethylurea (21, 32). 

Cerebrospinal fluid drain through ventriculostomy if hydrocephalus present... 

Laterra, L. and Goldstein, G.W., Ventricular organization of cerebral spinal fluid blood-brain barrier, brain edema, and hydrocephalus, in Principles of Neuroscience, 4th ed., Kandel, E.R., Schwartz, J.H., and Jessell, T.M., Eds., McGraw-Hill, New York, 2000, appendix B. 

Brettschneider, J., el al. (2004). Meningeal derived cerebrospinal fluid proteins in different forms of dementia is a meningopathy involved in normal pressure hydrocephalus J. Neurot Neurosurg. Psychiatry 75, 1614-16. 

Mase, M., et al. (2003). Lipocalin-type prostaglandin D synthase (beta-trace) in cerebrospinal fluid a useful marker for the diagnosis of normal pressure hydrocephalus. Neurosci. Res. 47, 455-9. 

Number of litters (number of fetuses in parentheses) affected. cOne fetus with anophthalmia and hydrocephalus. dAll anophthalmia or severe microphthalmia. 

Normal pressure hydrocephalus Urinary incontinence, difficulty walking... 

Table 10.4 lists the various medications that can be stopped and medical illnesses that can be treated to reverse dementia. In some cases, such as hypothyroidism or dehydration, the reversal can be complete. More often, the dementia is only partially reversed or its further progression is halted. Examples of these partial improvements include normal pressure hydrocephalus and vitamin B12 deficiency. 

To deal with the different disorders included in this section would be excessive therefore, we focus on dementia in Alzheimer s disease (AD]. Nevertheless, the less specific treatment options for AD are also complementary options to the usual treatment approaches for other forms of dementia or cognitive deficits in which etiological or more specific treatments may be useful (e.g., dementia in normal pressure hydrocephalus). 

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